Scorad index evolution in children with atopic dermatitis

Abstract

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease of the skin conditioned mostly by IgE allergic reactions genetic associated with atopy. It was proven that AD clinic evolution has some particularities related to the age, the severity of process and disease’s duration. The severity of the disease is appreciated by SCORAD index assessment (scoring atopic dermatitis). Objective: SCORAD index assessment in AD clinical evolution in children. Materials and methods: The study group consisted of 30 patients with AD (10 males, 20 females) with the age range between 2 months and 14 years. The diagnosis was based on patients' history, clinical and laboratory investigations. The dynamic of SCORAD index, total Ig E, CIC were assessed. SCORAD index was calculated in points, includes the evaluation of the process progression (affected area), the intensity of skin manifestations (erythema, oedema/papules, moist/crusted areas, excoriations, lichenification, xerosis) and the accuracy of subjective signs (itching, sleep disturbances), thus reflects the gravity of the process. The patients were divided into 3 groups by SCORAD index: I group- 8 patients with the index points below 20 (mild form), II group- 12 patients with SCORAD index ranged between 20 and 30 (moderate form), III group- 10 patients with the index>30 pts. (severe form). AD therapy included: diet therapy, local treatment with specific remedies of daily skin care, local anti-inflammatory and antihistamines remedies. Therapeutic efficacy was based on SCORAD index further determination. Results and discussions: The average SCORAD index for all the groups of study was 35,0 pts., in I group of study- 19,8 pts., II group-28,0 pts., Ill group-59,0 pts.. At the first reexamination in 7 days, average SCORAD index was 22,0 pts. (the index decreased with cca. 33%), after 12 days it consisted 10,4pts. (77% decreased from initial values). Xerosis extinction and clinical remission induction was noticed in 20 patients. In 10 patients (4 from II group and 6 from III group), a slow decreasing, till 30%, of the clinical signs was noticed. The individual analysis of these patients showed the presence of comorbidities (chronic amigdalitis, adenoiditis, gastroduodenitis), that needed prolonged further treatment. Conclusion: This study sustains the efficiency of the SCORAD index's prediction value in AD evolution assessment. SCORAD index decreasing in the study group reflects the treatment's efficacy. The presence of digestive system 's disturbances and of infections with focal chronic inflammation leads to a prolonged inflammatory dermic process and a prolonged therapy.